Use of Biventricular Assist Devices for Acute Heart Failure after Orthotopic Liver Transplantation: A Case Report

Background: Medical co-morbidities in liver transplantation augment surgical risk. We present this case report of a patient with immediate biventricular failure following transplant requiring VA ECMO and subsequent conversion to minimally invasive assist devices for cardiac recovery new graft preservation. Methods: 66-year-old male decompensated alcoholic cirrhotic pre-operative ECHO showing no valvular or CAD, EF 65%. He underwent on veno-venous bypass. TEE pre-reperfusion showed normal function. at end was approximately 10-16% dysfunction severe mitral regurgitation pressors inotropic support. Due continued poor perfusion function, the placed temporary stabilization support using an Impella® 5.5 (Abiomed, Danvers MA) LVAD via axillary artery Protek-Duo (CardiacAssist Inc, Pittsburgh PA) percutaneous RVAD right internal jugular vein. Results: Throughout POD 3-11, weaned off extubated close monitoring function (Figure 1). Serial TTEs myocardial were removed 8 13, respectively. The maintained throughout. TTE post mechanical removal his had improved 52%. Conclusion: This is first BIVAD used acute cardiogenic shock status transplantation. Myocardial stress setting alcohol abuse attributed global pump failure. Multidisciplinary team approach prompt ensured preservation while allowing recovery.